NHS Moves Slowly Toward Mobile Health IT

Doctors' demands mean the National Health Service's may soon be forced to allow smartphone and tablet use in clinical care.

9 Mobile EHRs Compete For Doctors' Attention

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According to a July 2012 report by U.K. state communications regulator Ofcom, 40% of U.K. adults now own a smartphone and the average Briton now sends 50 texts a week.

Nonetheless, most English hospitals still refuse to allow the use of cellphones in anything but non-clinical settings.

The problem of how to incorporate mobile technology in the National Health Service has a tortuous history. "We're behind in use of mobile as much as we are in many other areas with technology in the NHS," said Brian Gannon, director of the London office of a Belfast-based tech firm called Kainos.

"Its use is hugely fragmented. Let's be kind and say it's 'embryonic,'" he added.

Why? "Because it challenges the status quo, the accepted way of doing things, and starts changing workflows that haven't altered in years," he said. But, at a local level, individual hospitals are finally starting to explore how the power of mobile can be used to improve patient healthcare, and starting to use mobile electronic medical records (EMRs), Gannon said.

"Doctors and clinicians really are starting to demand these changes, especially with younger professionals in the field who just cannot understand why they are not able to use their iPads to help them work more efficiently on the ward," he told InformationWeek. And as a result, national mobile-intolerant NHS policies may end up being challenged and finally worn down, he predicted, leading to a possible surge in take-up of systems that use mobile broadband to connect to back-end hospital data systems.

Kainos markets a mobile health informatics system called Evolve that Gannon said is one of the
first such systems on the British health IT market. He said Kainos didn't plan it like this: The firm started life as a generic software house, but has recently gone beyond project work in general enterprise document management to focus on the U.K. health sector. At first they worked on ways to digitize medical back-office paper records, but found promise in the mobile EMR market.

Another believer in a new wave of mobile tech change on the U.K. health scene is Rashid Shahidi, CEO and co-founder of a British health apps vendor called Medopad. The system links front-end tablets and smartphones to back-end hospital systems like picture archiving and communication systems (PACS, or databases of medical scans) and other platforms. But he doesn't see his firm's market opportunity as being in the NHS at all, though, but rather private British hospitals, which he says are much less constrained.

"The NHS is a very large organization, where people tend to want to follow other people first; they won't move unless they see another solution working somewhere else first," he said. "The private sector in the U.K. is much more comfortable with mobile in hospitals as a result, [and] much happier, as it sees the benefits and wants to take advantage."

Though Shahidi says his company does not have any references as yet, Gannon's outfit points to one early customer for Kainos' mobile EMR approach: Bradford Teaching Hospitals. It went live last August with Evolve, using it as the basis of a new digital patient records system across its regional outpatient cochlear implant center in Yorkshire, a service that has a caseload of 650 patients, and sees 10 patients and performs two complex operations in an average week. The technology is being used to capture the results of consultations digitally within the clinic and issue legible, digital medical notes that can be shared by other clinicians.

"Staff are now able to access medical records simultaneously, even when a clinic is underway, and anesthetists can now access records before the date of an operation," said Mark Golding, EMR solution architect at Bradford. "The EMR project is a cornerstone of our transformational 'Going Digital' initiative, and we're excited by the way it's going and the progress already made."

Sounds great. But it may be some time yet before the NHS loses its fear of mobile and starts to see any sort of tablets in doctors' hands, other than the ones you swallow with water, it seems.

Regulatory requirements dominate, our research shows. The challenge is to innovate with technology, not just dot the i's and cross the t's. Also in the new, all-digital The Right Health IT Priorities? issue of InformationWeek Healthcare: Real change takes much more than technology. (Free registration required.)

Mobile technology has huge potential when it comes to the health IT field. With the power inherent in technology such as iPads and other tablets, it can be extremely useful. I think that in order to overcome the resistance from NHS towards mobile technology, the technology needs to be successfully implemented somewhere else. Once they see the benefits from this they will have to evolve and keep up with the technology of the times.

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